Abstract
Background and Aims
Many medical specialty trainees report a lack of confidence in hyperacute stroke management, contributing to inefficient patient care. We identified a lack of knowledge of our pathways, as well as difficulty managing human factors, particularly communication and teamwork. We hypothesised that the implementation of a simulation-based education programme could address these issues amongst medical specialty trainees and lead to improvements in our door-to-needle (DNT) times.
Methods
We organised a scenario-based simulation education session for our trainees led by a multi-disciplinary faculty. We addressed the management of acute ischaemic stroke, intracerebral haemorrhage, and basilar artery occlusion, as well as thrombolysis complications. Learners were surveyed before and after each session to gauge improvements in knowledge and confidence using a Likert scale. Free text feedback was sought from both learners and faculty to identify areas for improvement. We measured the mean DNT 3 months before and after our session.
Results
We improved both the knowledge and confidence of trainees in managing hyperacute stroke presentations and the human factors involved in a stroke pathway. We received feedback regarding the staffing of our on-call team and improving communication, including the use of lanyard cards and single point of contact devices. We also noted an improvement in our mean DNT amongst trainees who attended our training from 62mins to 34mins. Our resources were trialled in two other healthcare trusts to refine them further, before expanding the programme locally and regionally to improve training across all healthcare trusts.
Conclusions
Simulation education is beneficial in improving knowledge and confidence in the management of hyperacute stroke and can contribute to reduced DNT.